NHS will not offer puberty blockers to children suffering from gender dysphoria

Puberty blockers will not be routinely offered to children suffering from gender dysphoria, the NHS has said.

Clinicians and psychologists said the decision “will go down in history” in the safeguarding of children.

Guidance for two new regional gender clinics opening in England confirmed that the hormone-suppressing drugs would not be “routinely offered”.

The clinics will replace the controversial Tavistock gender clinic, which is closing after a damning independent review from Dr Hilary Cass deemed it “not safe”.

The Gender Identity Development Service (Gids), based at the Tavistock and Portman NHS Foundation Trust, London, was expected to close in spring this year, but it is still running. The reason for the delay is unknown.

A southern hub will open this autumn, but a northern hub is not expected to open until April 2024.

The Tavistock does not prescribe puberty blockers for children, but it can refer them for such drugs.

Clinical research only

On Friday, NHS England published an update following its previously stated intention to only commission puberty-suppressing hormones as part of clinical research.

It read: “We are... proposing that, outside of a research setting, puberty-suppressing hormones should not be routinely commissioned for children and adolescents who have gender incongruence/dysphoria.”

A spokesman confirmed that children treated at the new gender clinics would not be routinely offered puberty blockers as part of their treatment, but there may be exceptional circumstances in which a clinician could make a case for a child to have them.

‘Seismic’ decision

An independent review, led by Dr Cass, was commissioned in September 2020 amid a rise in demand, long waiting times for assessments, and “significant external scrutiny” around the London-based Gids clinic’s approach and capacity.

In 2021, the Court of Appeal ruled that children will be allowed to take puberty blockers without parental consent.

The NHS said it aimed to start a study by next year on the impact of puberty blockers on gender dysphoria in children and young people with early-onset gender dysphoria.

James Esses, co-founder of Thoughtful Therapists, which is focused on safeguarding children, said: “The fact that the NHS is holding firm on their intention to prevent the use of puberty blockers outside of the context of clinical trials is seismic.

“This will hopefully bring an end to vulnerable children being placed down a pathway to irreversible harm.”

‘Puberty blockers don’t help’

David Bell, a former governor turned whistleblower from Tavistock said: “All the evidence shows that puberty blockers don’t help, and there is clear evidence of physical and psychological harm caused by them, so this change is in line with the evidence we have.

“A very large percentage of children being treated for gender dysphoria have other problems such as autism and depression, and many are upset or confused about their sexuality.”

An NHS spokesman said: “The NHS is today publishing an interim specification for gender services for children and young people, in line with advice and recommendations from the Independent Cass Review. This will allow the new centres to finalise their preparation for service provision later this year.

“The NHS is now engaging on the proposal that puberty blockers will not be made routinely available outside of research. We will develop a study into the impact of puberty blockers on gender dysphoria in children and young people with early-onset gender dysphoria, which aims to be up and running in 2024.”

Safety risks

Meanwhile, campaigners warned that recent guidance presented to NHS bosses, saying patients may be found guilty of discrimination if they refuse the care of a transgender medic, posed dire risks to the safety of women.

Health bosses were warned that patients have no right to be told a healthcare worker’s assigned sex at birth.

However, transgender health workers can choose not to treat patients if they feel uncomfortable doing so, the report by NHS Confederation says.

Potential legal action

Helen Joyce, director of the gender-critical group Sex Matters, claimed a trans woman touching a patient who had requested a female doctor would amount to “assault”.

She said: “It is assault to be touched or manhandled by somebody who you said you are not explicitly willing to be.

“They are opening themselves up to legal action. [The guidance] is looking through the gender end of the telescope, not the sex end… It is heartless and evil.”

There is no statutory requirement for the NHS to provide a clinician of the same sex in any healthcare setting.

Most NHS trusts and healthcare professionals aim to offer a same-sex clinician for intimate care and examination upon patient request.